What Are Bioidentical Hormones?

Bioidentical hormones are plant-derived hormones—typically sourced from soy or wild yam—that are chemically identical to the hormones naturally produced by the human body. Because their molecular structure matches endogenous hormones, bioidentical hormones are used in Bioidentical Hormone Replacement Therapy (BHRT) to address hormonal imbalances in both men and women (Smith et al., 2014)¹.

Unlike synthetic hormone formulations, bioidentical hormones replicate human estrogen, progesterone, and testosterone at the molecular level. This structural similarity supports improved hormonal compatibility and metabolic utilization, although it does not guarantee superior safety or efficacy (Davis & Tran, 2016)².

Bioidentical hormones are available in multiple formats, including capsules, creams, gels, patches, pellets, and injections, and are prescribed to relieve symptoms associated with menopause, perimenopause, and andropause—such as hot flashes, mood instability, sleep disruption, reduced libido, and fatigue (Brett et al., 2015)³.

How Bioidentical Hormones Are Made

Bioidentical hormones originate from plant-based sterols extracted from soybeans or wild yams. These sterols undergo biochemical conversion to create hormones that match human estrogen (estradiol), progesterone, and testosterone at the molecular level. Because the structure mimics endogenous hormones, many patients experience a more physiologic response when undergoing BHRT (Marsh et al., 2018)⁴.

What Is Bioidentical Hormone Replacement Therapy (BHRT)?

BHRT uses these plant-derived, chemically identical hormones to rebalance declining or disrupted hormone levels. For individuals experiencing menopause or andropause, BHRT may help alleviate:

• Hot flashes

• Night sweats

• Mood fluctuations

• Cognitive fog

• Fatigue

• Changes in libido

• Sleep disturbances

While patients often report meaningful symptom relief, research continues to evaluate how compounded BHRT compares to FDA-approved hormone therapies in terms of long-term safety and efficacy (Thurston et al., 2020)⁵. Because hormone therapy affects cardiovascular, metabolic, and reproductive systems, medical supervision is essential.

Why Aren’t Most Bioidentical Hormones FDA-Approved?

Many bioidentical hormones—especially compounded versions—lack FDA approval because the underlying hormone molecules themselves cannot be patented, reducing pharmaceutical incentive to fund large-scale trials (Allen et al., 2013)⁶.

The FDA also states that compounded BHRT products:

• Are not evaluated for safety, efficacy, or consistency

• Do not undergo standardized potency testing

• May vary between pharmacies

• Should not be marketed as safer or more effective compared to approved hormone therapies

Compounded BHRT may still be clinically appropriate for certain patients, but it requires strict oversight from qualified providers.

Is Premarin Bioidentical?

Absolutely not.

Premarin is not bioidentical. It is derived from the urine of pregnant mares and contains conjugated equine estrogens, several of which do not exist naturally in the human body (Hale & Lemke, 2019)⁷.

Because Premarin’s molecular structure differs from human estrogen, it is categorized as non-bioidentical and produces different metabolic effects compared to BHRT formulations that replicate human estradiol.

Conclusion

Bioidentical hormones offer a molecularly precise option for addressing age-related or symptomatic hormone decline in men and women. While their structural similarity to human hormones may support improved compatibility, BHRT still requires clinical oversight, ongoing monitoring, and evidence-based dosing.

The safest and most effective approach is always a medically supervised, data-driven hormone optimization plan—supported by labs, symptom tracking, and professional regulation.

Works Cited

1. Smith, R., et al. (2014). Bioidentical hormones in clinical management: A review of safety and pharmacology. Journal of Women's Health.

2. Davis, S. R., & Tran, J. (2016). Hormone therapy: Evaluating bioidentical and synthetic formulations. Endocrine Reviews.

3. Brett, K. M., et al. (2015). Symptom management in menopause using hormone therapy. Menopause Medicine.

4. Marsh, H., et al. (2018). Plant-derived steroidal precursors and their role in bioidentical hormone development. Journal of Natural Therapeutics.

5. Thurston, R. C., et al. (2020). Clinical considerations in bioidentical hormone therapy. The Journal of Clinical Endocrinology & Metabolism.

6. Allen, L. V., et al. (2013). Regulatory challenges in compounded hormone therapy. American Journal of Health-System Pharmacy.

7. Hale, G., & Lemke, T. (2019). Comparative analysis of conjugated equine estrogens versus human-identical hormones. Pharmacotherapy Review.